Telehealth-Delivered Dietary Counseling in Myeloproliferative Neoplasms: A Randomized Feasibility Study

Background/Objectives: Patients with myeloproliferative neoplasms (MPNs) experience chronic inflammation, elevated cardiovascular risk, and substantial symptom burden. Dietary patterns with anti-inflammatory and cardioprotective effects may represent a modifiable strategy to address these overlapping risks, yet dietary intervention has not been systematically studied in MPN. We evaluated the feasibility, engagement, and preliminary clinical signals of a fully remote dietary counseling intervention in adults with MPN. Methods: In this single-center, randomized, open-label pilot study, 28 adults with polycythemia vera, essential thrombocythemia, or primary myelofibrosis were randomized 1:1 to Mediterranean (MED) or Dietary Approaches to Stop Hypertension (DASH) dietary counseling over 10 weeks. The protocol included a 2-week baseline run-in period, 10-week active intervention with four telehealth dietitian visits, and 4-week postintervention follow-up. Prespecified feasibility endpoints were the completion of dietitian visits, daily MPN Symptom Assessment Form Total Symptom Score (MPN-SAF TSS) surveys, Mediterranean Diet Adherence Screener (MEDAS) questionnaires, and Automated Self-Administered 24-Hour Dietary Recall (ASA24) assessments. Exploratory endpoints included the change in Healthy Eating Index 2015 (HEI-2015) and symptom burden. Results: Twenty-seven participants provided data and were analyzed (14 MED, 13 DASH). Dietitian visit attendance was 96% (MED) and 85% (DASH). Daily symptom survey completion averaged 93% (MED) and 58% (DASH). MEDAS completion was 81% (MED) and 51% (DASH); ASA24 completion was 55% (MED) and 38% (DASH). HEI-2015 increased from 55 to 63 in MED during active intervention. At week 12, 23% of MED and 13% of DASH participants achieved ≥50% TSS reduction. Symptom reductions were observed across multiple domains. Conclusions: A fully remote dietary intervention is feasible in adults with MPN, with strong engagement in the Mediterranean arm. These findings support adequately powered trials incorporating biomarker endpoints to evaluate dietary modification as a strategy for inflammation-driven symptoms and cardiovascular risk in MPN.